Purpose: The purpose of this experiment was to evaluate the clinical effect of cultured autoglogous osteoblasts as a way to treat the defect of mandible in rabbits. Materials and Methods: Twelve rabbits were used to determine the rate of osteogenesis. The osteoblasts were obtained from the iliac crest of rabbits using aspiration. They were then cultured in Dulbecco's Modified Eagles's Medium (DMEM) with beta-glycerophosophatate, L-ascorbicacid, and dexamethasone to proliferate and differentiate osteoprogenitor cells. The expression of osteogenic markers were detected by reverse transcription-polymerase chain reaction (RT-PCR) and silver nitrate staining techniques. Five, 10-mm holes were placed in each rabbit mandible to simulate defective regions with the use of a low speed trephine bur. In the experimental group, the previously cited defects were grafted with both activated osteoblastic and autogenous bone. The control group, however, was only grafted with autogenous bone. Both groups were then analyzed at 2, 4, and 8-week intervals using bone histomorphometric analysis. Results: According to histomorphologic analysis, the rates of new bone formation at the 2, 4, and 8-week intervals were 36%, 51%, and 23% for the control group, respectively; 52%, 39%, and 28%, for the experimental group, respectively. The experimental group showed higher rates of new bone formation compared to the control group at both the 2-week and 8-week interval. Conclusion: Bone marrow-derived osteoblasts seems to be a promising bone graft material.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.27
no.6
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pp.498-510
/
2001
Distraction osteogenesis refers to the biological process responsible for new bone formation between bone segments by gradual distraction after osteotomy. For the past several years, various inconveniences including a protracted consolidation period that requires patients to wear a distractor frame longer, as well as higher medical costs, have not been remedied by improvements in osteotomy, distraction rate and monitoring system. Furthermore, side effects such as pin tract infections and soft tissue swelling may arise due to the long treatment period. These drawbacks form the rationale of this study which purports to seek a method by which the consolidation period can be reduced. This paper examines how platelet-rich plasma(PRP), known to facilitate osteogenesis, influences bone formation when applied in distracted area. Ten mongrel dogs, which were made to wear external distractor frames after osteotomy in both sides of the mandible, were used as subjects. After a 7day period of latency, distraction was carried out at a rate of 1mm/day for 14 consecutive days. After the onset of distraction, 2ml of PRP and a mixture of calcium gluconate and thrombine were injected into the center of the distracted callus on the left side of the mandible. The left was injected with PRP while the right side was set as the control site without PRP treatment. Execution at the onset of distraction and in 2 weeks, 4 weeks and 8 weeks after the consolidation period, clinical and radiographic tests, bone mineral density examination, histological examination and histomorphometric analysis were conducted to compare both sides. The results are summarized as follows: 1. Based on the clinical examination at two weeks, more remarkable cortical bone formation was found on the buccal and lingual side of the distracted area in the PRP treatment site than in the control site. No visual difference was found between the PRP treatment site and the control site at four eight weeks. 2. Based on the radiological examination, a distinct increase in the radiopaque appearance of the PRP treatment site was revealed at two weeks, but this increase appeared to slow down at four and eight weeks. 3. Examination of bone mineral density revealed a significant difference at two weeks with the PRP treatment site yielding density two times higher than the control site. This difference lessened after four weeks, and disappeared at eight weeks. 4. The histomorphometric examination revealed that about 20% more bony trabeculae area(20%, higher) was formed in the PRP treatment site than in the control site. In conclusion, it can be said that PRPs effect on stimulating bone formation in the PRP treatment site manifest as early as two weeks. Trabeculae formation likewise increased throughout the whole period. If this result can be applied to humans, the consolidation period can be reduced by injecting PRP into the distracted area.
Purpose : The purpose of this study is to evaluate the clinical outcomes and radiological changes after reconstruction of anterior cruciate ligament with human allograft. Material and Method : Authors analyzed 22 cases of anterior cruciate ligament allograft reconstruction which were done from January, 1995 to December, 1998 and could be followed up for a year or more. All cases were followed and reviewed in terms of anterior drawer test, Lachman test, Pivot shift test, radiographic examination, knee range of motion, and side-to-side difference of anteroior tibial translation using CA-4000 knee motion analyzer, and Lysholm knee scoring system. Result : The mean Lysholm knee score was 54 preoperatively and improved to 81 postoperatively by average of 27. The side-to-side difference of anterior tibial translation using CA-4000 knee motion analyser was less than 3 mm in 16 cases$(73\%)$, between 3 and 5 mm in 4 cases$(18\%)$, and greater than 6 min in 2 cases$(9\%)$. Average tibial tunnel enlargement was 1.5 mm, but there were not any osteoiysis or cystic formation along the tunnel and no relationship between tunnel enlargement and clinical outcome. Conclusion : Although this study had limited cases, clinical results of anterior cruciate allograft reconstruction were similar to those of reconstruction with autograft reported in the literatures. We think that allograft is an acceptable substitute fer autograft in anterior cruciate ligament reconstruction.
The synoptic, thermodynamic, and dynamic characteristics of a heavy snowfall event that occurred in Seoul metropolitan area on 27 to 28 December 2010 was investigated. During this period there was a distinctive case that was identified as a polar low. We analyzed surface and upper level weather charts, snowfall amount, sea surface temperature, satellite imagery, sounding, and the National Center for Environmental Prediction global $1^{\circ}{\times}1^{\circ}$ reanalysis data. The polar low developed in an area where there was strong baroclinicity in the lower level aided by strong conditional instability due to 925 hPa warm air advection and 700 hPa cold air advection. The development mechanism of polar low is due, in part, to the tropopause folding, which advected stratospheric air increasing potential vorticity in mid-level and inducing cyclonic vorticity and convergence in low-level. Eventually clouds developed and there were snowfall total of 10 cm in Seoul metropolitan area and as much as 20 cm in southern parts of Korea. During the snowfall development, there was a $-45^{\circ}C$ cold core at 500 hPa and shortwave maintained $3-5^{\circ}$ separation with surface trough, which favored the development of polar low located in the warm sector and cyclonic advection area. The height of the dynamical tropopause lowered to 700 hPa during the peak development and increase in potential vorticity allowed strong vertical motion to occur. Overall, there was a close relationship between the development of snowfall and tropopause undulation. The heaviest snowfall occurred east of the tropopause folding where strong cyclonic vorticity, vertical motion, and moisture advection all coincided while the polar low was passing through the Korean peninsula.
Statement of problem: An orthodontic miniscrew implant has been used as a skeletal anchorage for orthodontic treatment. However, any relation among the influence of the cortical bone, morphologic differences of orthodontic miniscrew implants and new bone formation hasn't been made clear yet. Purpose: The purpose of this study was to evaluate whether the orthodontic miniscrew implant could work as an intraoral skeletal anchorage immediately and stably for orthodontic treatment after insertion of it. Material and methods: Two types of orthodontic miniscrew implants were used in this experiment; tapered type and straight type. One hundred and sixty eight orthodontic miniscrew implants were inserted into the tibiae of 21 rabbits and sacrificed on 3, 7, 11, 14, 21 and 28days later after insertion of them to study removal torque values and histologic and histomorphometric analyses. Results: The results were as follows. 1. The removal torque values of the tapered type were higher than those of the straight type in all groups(p<0.05). 2. There wasn't any distinguishing differences between the tapered type and the straight type about the new bone formation percentage. 3. The removal torque values for both the tapered type and the straight type were gradually decreased at early stages of the test but started to increase at the 7 days group of the straight type and the 11 days group of the tapered type. 4. New bone formation percentage was increased gradually for both the tapered and the straight types as time passed(p<0.05). 5. It was found that the tapered type showed lower values in the cortical bone about both the maximum equilibratory stress distribution and the maximum principal stress distribution than the straight type in linear finite elements analysis. Conclusion: According to the research, the removal torque values were decreased at 7 days group of the tapered type and 11 days group of the straight type after the insertion of the orthodontic miniscrew implants in tibiae of rabbits. Considering the human bone activity, it is better to apply the orthodontic force $3{\sim}4$ weeks later than to apply it immediately after the insertion of orthodontic miniscrew implants. Considering that general orthodontic force is about $250{\sim}500$ grams, the tapered type can be worked as a stable skeletal anchor age in an orthodontic treatment even if the orthodontic force is applied on it immediately after the insertion of it.
Journal of the korean academy of Pediatric Dentistry
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v.31
no.1
/
pp.34-40
/
2004
Unerupted maxillary anterior teeth is not a common case, However it may present practitioners with management problem. The cause of impaction is considered to be multifactorial, and local cause is the most common. These impacted teeth require surgical intervention, removal, transplantation, or surgical exposure, with or without orthodontic traction to align the malpositioned tooth. The preferred option is surgical exposure and orthodontic correction. Surgical intervention and orthodontic correction should not be delayed to avoid unnecessary difficulties in aligning the tooth in the arch. Surgical exposure should be performed with the intent of providing sufficient attached gingiva rather than simply uncovering the crown, which results in only alveolar mucosal attachment. Attached gingiva is essential to secure the gingival tissues to the adjacent teeth at the dentogingival junction. Thus preventing loss of periodontal tissues as a result of the pull of the surrounding soft tissues and facial muscles. Labially impacted maxillary anterior teeth uncovered with an apically positioned flap technique have more un- esthetic sequelae than those uncovered with a closed-eruption technique. In the case of severly displaced impacted teeth, autotransplantation ensures preservation of the alveolar bone and will facilitate future placement of an osseointegrated implant once growth has ceased or if ankylosis/resorption of the transplant occurs.
Journal of the korean academy of Pediatric Dentistry
/
v.35
no.4
/
pp.597-606
/
2008
Resorption of alveolar bone in periodontitis is due to excessive differentiation and activation of osteoclasts. Bacterial antigens causing periodontitis activates CD4 T cells, which leads to expressing RANK ligand (RANKL) on CD4 T cells. RANKL binds RANK on preosteoclasts or osteoclasts, and enhances the differentiation preosteoclasts into osteoclasts and the activation of mature osteoclasts. CD137, one of TNF receptor (TNFR) family, expressed on activated T cells binds with CD137 ligand (CD137L) on antigen presenting cells. Cross-linking of CD137 by CD137L acts as T cell co-stimulatory signals and, therefore, enhances the activation of T cell. In this study, I elucidated the biological responses of CD137L on (pre)osteoclasts and RANKL on T cells in the context of in vivo interaction between T cells and osteoclasts. RAW264.7, murine monocytic cells, constitutively express CD137L. Ligation of CD137L with anti-CD137L mAb inhibited RANKL-induced osteoclast formation in a dosedependent manner. Bone marrow cells are expressed CD137L by the treatment with M-CSF. Cross-linking of CD137L abolished M-CSF/ RANKL-evoked the formation of multi-nucleated osteoclasts. Both mouse CD4 and CD8 T cells are expressed RANKL following their activation. Ligation of RANKL with OPG, the decoy receptor for RANKL, inhibited both CD4 and CD8 T cell proliferation. These effects were attributed to RANKL-induced apoptosis. These data indicate that CD137L and RANKL on osteoclasts and T cells, respectively provide them with inhibitory signal.
Nasal bone fracture is common in mid-facial trauma patients. In these patients, facial bone and nasal bone fracture are reducted at same time, but definite nasal reduction is difficulty in these patients because of nasotracheal intubation during general anesthesia and facial swelling in early facial trauma patients. If nasal packing and MMF are needed, there are difficult to maintain the reducted nasal bone because of some difficulty in airway maintenance after nasal packing and increasing the patient discomfort. So postoperative nasal deformity is more common in these combined patients. Secondary rhinoplasty is necessary in these patients who have deformed nasal bone, and there are many methods and materials for secondary rhinoplasty. But if primary nasal bone was reducted symmetrically, it is easy in secondary rhinoplasty. We present 7 cases of secondary rhinoplasty in mid-facial trauma patients who had combined nasal bone fracture. In these patients, primary nasal bone reduction carried with closed reduction method during primary facial bone reduction. About 6 months later, we performed secondary rhinoplasty with iliac bone and alloplastic materials. So we report these cases with literatures.
Optimal orthodontic treatment could be possible when a orthodontist can predict and control tooth movement by applying a planned force system to the dentition. The moment to force(M/F) ratio at the bracket, has been shown to be a primary determinate of the pattern of tooth movement. As various n/F ratios are applied to the bracket on the tooth crown, strain distribution in periodontium can be changed, and the center of rotation in tooth movement can be determined. It is, therefore, so important in clinicalorthodontics to know the strain distribution in a force system of a M/F ratio. The purpose of this study was to analyze the strain distribution in orthodontic force system by strain gauge attached to tooth root, and to evaluate the usage of the method. For this study, an experimental upper anterior arch model was constructed, where upper central incisors, on the root surface of which, 8 strain gauges were attached, were implanted In the photoelastic resin, as in the case of 4mm midline diastema. Three types of closing of upper midline diastema closure were compared : 1. with elastomeric chain(100g force) in no arch wire, 2. elastomeric chain in .016“ round steel wire, 3. elastomeric chain in .016”x.022“ rectangular steel wire. The results were as follows. 1. Strain distributions on labial, lingual, mesial and distal root surface of tooth were able to be evaluated with the strain gauge method, and the patterns of tooth rotation were understood by presuming the location of moment arm. 2. Extrusion and tipping movement of tooth was seen in closing in no arch wire, and intrusion and bodily movement was seen with steel arch wire inserted.
Park, Hee-Suk;Kim, Young-Jin;Kim, Hyun-Jung;Nam, Soon-Hyeun
Journal of the korean academy of Pediatric Dentistry
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v.36
no.3
/
pp.456-463
/
2009
Cleidocranial dysplasia(CCD) is a congenital disorder of skeletal and dental abnormality, which is a mesodermal dysfunction influencing many tisssues and organs. Skeletal abnormalities in CCD are delayed closure of cranial suture and fontanelle, presence of wormian bone and clavicle aplasia. CCD also has an effect on long bones, phalanges, spine, pelvis, muscles, and central nervous system. Dental manifestations include retention of deciduous teeth, multiple supernumerary teeth, delayed eruption or impaction of permanent teeth and formation of cysts around nonerupted teeth. However, due to lack of any substansive medical or physical disability, diagnosis is often late, thereby causing masticatory and psychological problems caused by delayed eruption of permanent teeth after exfoliation of deciduous teeth. For this reason, CCD requires early diagnosis, and the patient's appearance must be improved. Also, provision for a functional masticatiory mechanism by treatment of surgical removal of supernumerary teeth followed by orthodontic eruption of the natural permanent teeth at an adequate time is necessary.
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